Coping with the loss of a loved one is already a challenging experience. But what happens if your expected life insurance claim is denied during such a difficult time? Sadly, life insurance companies do deny countless claims each year, leaving grieving families without the financial support they were counting on. Understanding why these claims are denied and knowing how to navigate the process is crucial for protecting your family’s future.
Dealing with complex claims like VGLI (Veterans’ Group Life Insurance), SGLI (Servicemembers’ Group Life Insurance), TSGLI (Traumatic Servicemembers’ Group Life Insurance), and Prudential claims requires expert legal support. Handling these types of claims without a life insurance attorney with at least 20 years of experience can be a costly mistake.
A claim denial often arrives at the worst possible time—right when you’re dealing with the emotional and financial toll of losing a loved one. For many beneficiaries, a life insurance denial isn’t just an inconvenience; it becomes a major burden that adds even more strain to an already difficult situation. So, what should you do if your claim is denied?
What to Do If Your Life Insurance Claim is Denied
Document Everything
The first step is to keep a meticulous record of all documents and correspondence with the insurance company. Save every letter, form, and any other piece of paperwork you receive from them. It’s important to scan and organize these documents so they are ready to send to your attorney. Additionally, keep a record of each conversation you have with the insurance company, including the names of representatives, dates, and topics discussed.
Locate the Original Policy and Proof of Payment
Next, gather the original life insurance policy documents, including any amendments or change notices. You should also locate proof that premiums were paid regularly. This evidence will be vital when challenging the claim denial.
Determine the Reason for the Denial
Your insurer should provide a clear reason for refusing to pay the claim. It’s critical to understand exactly why the claim was denied, as this will guide your next steps. Common reasons for denial include:
Failure to Pay Premiums: The insurer may claim the deceased missed a premium payment or failed to pay on time, causing the policy to lapse.
Misrepresentation or Incorrect Information on the Application: The insurance company may argue that the deceased misrepresented key details such as age, weight, health status, or other factors during the application process.
Policy Exclusions: Certain exclusions, such as death from suicide, extreme sports, or hazardous activities, can render the policy invalid depending on the terms of the contract.
Paperwork Errors: Mistakes made by the employer or the beneficiary in submitting the claim can also lead to a denial. For group life policies, errors can sometimes occur in the paperwork process.
Beneficiary Designation Issues: If the beneficiary listed in the policy is either missing, incorrect, or conflicts with a court order or legal stipulation, it could result in a denial.
Key terms you'll hear when dealing with these claims include: service member, active duty, Servicemembers’ Group Life Insurance (SGLI), death benefits, Veterans’ Group Life Insurance (VGLI), premium payments, and VGLI coverage.
Speak to a Life Insurance Lawyer with 20+ Years of Experience
Attempting to handle a denied life insurance claim on your own can permanently damage your case. This is especially true for group life policies governed by ERISA (Employee Retirement Income Security Act), which allows only one appeal. If you miss your chance, the appeal process is closed, and you may lose the right to pursue the claim further.
An experienced life insurance lawyer, ideally with at least 20 years of experience, can make all the difference. Our legal team knows the ins and outs of life insurance claims and how to handle complex cases like VGLI, SGLI, and Prudential claims. We routinely submit 100-200-page legal briefs that usually result in favorable outcomes without needing to go to court.
Why You Need an Experienced Life Insurance Attorney
The fastest and most effective way to resolve your denied claim is to work with an experienced attorney. At our firm, we specialize in handling both delayed and denied life insurance claims. Our team is dedicated to fighting for the benefits you are owed. We understand the emotional and financial stress that comes with dealing with claim denials, and we’ll work tirelessly to ensure that you receive the full policy amount, plus any applicable interest.
Get the Help You Deserve
If your life insurance claim has been denied or is experiencing delays, don’t wait. Contact us today for a consultation with one of our experienced life insurance attorneys. We’ll discuss the specifics of your case, explain your options, and begin working on the best course of action to get the claim resolved.